2019—2022年青岛市城阳区“三高共管六病同防”慢病管理模式下患者血压、血糖、血脂控制变化趋势及影响因素分析  

Trends and influencing factors of high blood pressure/glucose/lipids control among community patients under the"Integrated Control and Prevention of Three Highs and Six Diseases"strategy in a district of Qingdao city:an analysis of 2019–2022 surveillanc

作　　者：范文瑜 张世龙 王海鹏 马兴丽[1,2] 张高辉 陈良侠[3] 齐聪[3] 杜雪莹 赵洋 FAN Wenyu;ZHANG Shilong;WANG Haipeng;MA Xingli;ZHANG Gaohui;CHEN Liangxia;QI Cong;DU Xueying;ZHAO Yang(Centre for Health Management and Policy Research,School of Public Health,Cheeloo College of Medicine,Shandong University,Jinan 250012,China;National Health CommissionKey Lab of Health Economics and Policy Research(Shandong University),Jinan 250012,China;Department of Health Management,Shandong Center for Disease Control and Prevention,Jinan 250014,China;The George Institute for Global Health,University of New South Wales,Sydney 2050,Australia;Melbourne School of Population and Global Health,The University of Melbourne,Melbourne 3010,Australia)

机构地区：[1]山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心,济南250012 [2]国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学),济南250012 [3]山东省疾病预防控制中心健康管理所,济南250014 [4]新南威尔士大学乔治全球健康研究院,悉尼澳大利亚2050 [5]墨尔本大学人口与全球健康学院,墨尔本澳大利亚3010

出　　处：《中国公共卫生》2025年第2期148-153,共6页Chinese Journal of Public Health

基　　金：国家重点研发计划项目重点专项(2020YFC2006500,2020YFC2006505)。

摘　　要：目的探讨“三高共管六病同防”慢性病管理模式下“三高”患者血压、血糖、血脂控制的影响因素,为改进慢性病管理模式提供参考依据。方法利用山东省青岛市城阳区“三高”管理信息系统数据,选取纳入“三高共管六病同防”管理模式的60岁及以上且在2019—2022年连续4年进行了血压、血糖和血脂的监测的34500例“三高”患者作为研究对象。采用广义估计方程分析该模式下血压、血糖、血脂控制的影响因素。结果血压控制达标率整体上呈先下降后上升趋势,2019年为27.04%,2021年下降到26.07%,2022年上升到27.88%。血糖控制达标率整体呈现先下降后上升的趋势,2019年为60.07%,2021年下降到52.20%,2022年又上升到55.30%。血脂控制达标率整体上呈先下降后上升趋势,2019年为55.20%,2020年下降到54.14%,2022年上升到60.95%。女性、年龄大、本地户籍、文盲或半文盲、务农、三高种类多、用药种类多的患者血压控制达标率更低;男性、60~69岁、本地户籍、文盲或半文盲、务农、三高种类多、用药种类多的患者血糖控制达标率更低;女性、60~69岁、本地户籍、文盲或半文盲、其他职业、三高种类多、用药种类少的患者血脂控制达标率更低。结论在“三高共管六病同防”慢性病管理模式下,青岛市城阳区“三高”患者血压、血脂的达标率得到了有效提高,血糖控制达标率也得到了改善。未来还需加强对重点人群的生活习惯干预和健康教育管理,持续开展效果评价,改进和完善慢性病管理模式。Objective To study the factors influencing the control of high blood pressure/glucose/lipids in community patients under the strategy of"Integrated Control and Prevention of Three Highs(high blood pressure/glucose/lipids)and Six Diseases(coronary heart disease,stroke,renal lesions,retinal lesions,peripheral neuropathy,and peripheral vascular lesions)"strategy,and to provide a reference for improving the chronic disease management model.Methods The study included 34500 elderly residents(≥60 years)with one or more elevated blood pressure/glucose/lipid levels who were under the management of"Integrated Control and Prevention of Three Highs and Six Diseases"strategy in Chengyang district,Qingdao city,Shandong province.Subjects′demographics and 4 years(2019–2022)of consecutive blood pressure,glucose,and lipid monitoring data were collected from the Three Highs management information system.Generalized estimating equations were used to analyze the factors influencing the subjects′blood pressure,blood glucose,and blood lipid control.Results The overall blood pressure control rate showed a trend of first decreasing and then increasing,from 27.04%in 2019,decreasing to 26.07%in 2021,and then increasing to 27.88%in 2022.The overall blood glucose control rate also showed a trend of first decreasing and then increasing,from 60.07%in 2019,decreasing to 52.20%in 2021,and then increasing to 55.30%in 2022.The overall blood lipid control rate showed a trend of first decreasing and then increasing,from 55.20%in 2019,decreasing to 54.14%in 2020,and then increasing to 60.95%in2022.Patients who were female,older,had local household registration,were illiterate or semi-literate,worked in agriculture,had multiple elevated blood pressure/glucose/lipid levels,and used more medications had lower blood pressure control rates.Patients who were male,aged 60–69 years,had local household registration,were illiterate or semi-literate,worked in agriculture,had multiple elevated blood pressure/glucose/lipid levels,and used more medicatio

关 键 词："三高共管六病同防" 慢性病管理模式 血压 血糖 血脂 

分 类 号：R47[医药卫生—护理学]